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Medientyp: E-Artikel Titel: Dislocation of the rotating cutter during directional coronary atherectomy: A note of caution Beteiligte: Bauriedel, Gerhard; Schluckebier, Sven; Welsch, Ulrich; Werdan, Karl; Höfling, Berthold Erschienen: Wiley, 1995 Erschienen in: Catheterization and Cardiovascular Diagnosis Sprache: Englisch DOI: 10.1002/ccd.1810350319 ISSN: 0098-6569; 1097-0304 Schlagwörter: Cardiology and Cardiovascular Medicine Entstehung: Anmerkungen: Beschreibung: <jats:title>Abstract</jats:title><jats:p>Directional coronary atherectomy (DCA) has received increased attention, especially as a bail‐out procedure after failed balloon angioplasty. However, this technique may also be burdened by severe pitfalls. We report a patient with a balloon‐resistant left coronary artery lesion subsequently treated with DCA. Despite its over‐the‐wire guidance, as the rotating cutter was advanced, it deviated from its intra‐housing course and intruded into the vascular wall. Dislocation of the rotating blade was due to pressure from hard plaque tissue. After having carefully pulled back the complete catheter system, a severe spasm of the left main stem occurred, which was reversed by intracoronary nitroglycerine. The final angiography showed a left coronary artery without significant, residual stenosis. The case report underscores that DCA passes must be performed under continous fluoroscopic control, especially for balloon‐resistant lesions because of the unpredictability of DCA‐imminent complication. © 1995 Wiley‐Liss, Inc.</jats:p>